DRY EYES

The  continuous production and drainage of tears is important to the eye's  health. Tears keep the eye moist, help wounds heal, and protect against  eye infection. In people with dry eye, the eye produces fewer or less  quality tears and is unable to keep its surface lubricated and  comfortable.

The tear film consists of three layers--an outer,  oily (lipid) layer that keeps tears from evaporating too quickly and  helps tears remain on the eye; a middle (aqueous) layer that nourishes  the cornea and conjunctiva; and a bottom (mucin) layer that helps to  spread the aqueous layer across the eye to ensure that the eye remains  wet. As we age, the eyes usually produce fewer tears. Also, in some  cases, the lipid and mucin layers produced by the eye are of such poor  quality that tears cannot remain in the eye long enough to keep the eye  sufficiently lubricated.

The main symptom of dry eye is usually a  scratchy or sandy feeling as if something is in the eye. Other symptoms  may include stinging or burning of the eye; episodes of excess tearing  that follow periods of very dry sensation; a stringy discharge from the  eye; and pain and redness of the eye. Sometimes people with dry eye  experience heaviness of the eyelids or blurred, changing, or decreased  vision, although loss of vision is uncommon.

Dry eye is more  common in women, especially after menopause. Surprisingly, some people  with dry eye may have tears that run down their cheeks. This is because  the eye may be producing less of the lipid and mucin layers of the tear  film, which help keep tears in the eye. When this happens, tears do not  stay in the eye long enough to thoroughly moisten it.

Dry eye can  occur in climates with dry air, as well as with the use of some drugs,  including antihistamines, nasal decongestants, tranquilizers, and  anti-depressant drugs. People with dry eye should let their health care  providers know all the medications they are taking, since some of them  may intensify dry eye symptoms.

People with connective tissue  diseases, such as rheumatoid arthritis, can also develop dry eye. It is  important to note that dry eye is sometimes a symptom of Sjögren's  syndrome, a disease that attacks the body's lubricating glands, such as  the tear and salivary glands. A complete physical examination may  diagnose any underlying diseases.

Artificial tears, which  lubricate the eye, are the principal treatment for dry eye. They are  available over-the-counter as eye drops. Sterile ointments are sometimes  used at night to help prevent the eye from drying. Using humidifiers,  wearing wrap-around glasses when outside, and avoiding outside windy and  dry conditions may bring relief. For people with severe cases of dry  eye, temporary or permanent closure of the tear drain (small openings at  the inner corner of the eyelids where tears drain from the eye) may be  helpful.  Our doctors are experts in the treatment of dry eyes using preservative tears, ointments, autologous serum, punctal plugs and prescription drugs.